Response from Nestle to PHDinParenting – Part 2

–>see my experience at the Happy, Healthy Gathering at Nestle USA event

–>see “Response from Nestle to PHDinParenting” – Part 1 & Part 3

Annie’s (from questions are in bold.


October 9, 2009

Dear Annie,

Thank you for your patience.  Attached are our responses to more of your questions. We will continue to forward responses as we receive them.


Edie Burge

You say that you comply with the WHO International Code of Marketing of Breast-Milk Substitutes in all countries that have adopted the code. Canada is a signatory to the Code and the Canadian government actively encourages companies to comply with it. However, despite Canada being a signatory to the Code, you do not comply with the code in Canada. When you say “adopted” is it fair to assume then that you mean “legislated” and that you will not comply with a developed country’s will unless it puts regulations in place to force you to?

The WHO Code was adopted by the WHO Member States as a recommendation to governments, which are required to implement the Code as appropriate to their social end legislative framework. Nestlé universally follows all countries’ implementation of the WHO Code.

In addition, Nestlé decided over two decades ago to voluntarily and unilaterally apply the WHO Code in all developing countries, whether or not they have implemented it in their own legislative framework. If the local legislation is stricter than the Code, we apply local legislation.

You mention that “The WHO Code will only truly succeed if governments enforce it and monitor its compliance“. When a country is considering changing its legislation to include provisions contained in the WHO Code does Nestle lobby against those changes through formal or informal consultation processes?

No, it is not in Nestlé’s interest to have weak national codes in place; we apply the WHO Code and the Nestlé instructions if the national code is less strict than the WHO Code itself.

A strong national legislation, that includes monitoring procedures, provides clarity and an even playing field for all infant formula manufacturers. Therefore, Nestlé encourages governments to implement monitoring mechanisms. The Code itself also recommends this.

You say that you do not market formula in developing countriessay that you have unilaterally applied the WHO Code in all developing countries and regions Please:

  • Provide a list of developing countries where you sell infant formula (i.e. the countries where you do sell, but do not market your formula)

This is the list of countries that we define as developing countries when it relates to the implementation of the WHO Code. All countries in Central Asia, and all countries or territories of Africa, Middle East, Asia, Latin America, the Caribbean nations and the Pacific nations except Japan, Australia, New Zealand, Republic of Korea, Singapore, Taiwan and Hong Kong.

The categorisation of a country as developing or developed is subject to objective criteria, such as infant mortality rate, adult literacy rate, Gross National Income per capita, percentage of infants with low birth weight, percentage of population using improved water sources and percentage of population urbanised.

Our definition of “marketing” is the same as the one given in the WHO Code (art. 3). By “marketing we mean: product promotion, distribution, selling, advertising, product public relations, and information services.”

Does any Nestle formula packaging in any nation make claims that the formula offers protection or protects the baby against diarrhea or any other ailment?

There is no question about breast milk being the best start a baby can have in life. But when mothers are not able to breastfeed, it is critically important that a safe, effective, high-quality alternative be made available.

Nestlé  makes significant investments in R&D and technology to deliver innovative products with scientifically proven nutritional benefits.  While our infant nutrition products meet the needs of non-breastfed babies during the first critical months of life, the functional benefits that are referred to on our products are scientifically substantiated – the result of many years of intensive research on how best to improve the formula composition.  However, we never claim in any manner that infant formula is superior to breast milk. All our infant formula labels contain the following text: “Important notice: Breast milk is best for babies. Before you decide to use an infant formula, consult your doctor or clinic for advice.”

You maintain that “Nestle does not provide mothers in the developing world with free samples of your infant formula products – in fact Nestle has no contact at all with mothers with regards to these“. Are samples provided to doctors? Is information about the “benefits” of your formula provided to doctors or other health professionals?

Nestlé  does not provide mothers in the developing world with free samples of products. Samples of formula may be provided to individual health workers for the exclusive purpose of professional evaluation and in very specific instances (e.g. introduction of a new formula product). In such cases, the health worker may only be given one or two cans of the product and one time only. When in contact with health workers, Nestlé staff emphasises the superiority of breast-feeding and gives objective information on scientific and factual matters pertaining to formula and its correct use.

You indicate that you have regular audits on a worldwide basis of your marketing practices relating to infant formula. Do you have any public audit reports and/or statistics that you can share?

Nestlé  has implemented a thorough monitoring system to ensure compliance with the WHO Code. This includes an internal WHO Code Ombudsman System that allows Nestlé employees to alert the Company on potential non-compliance with the WHO Code, regular internal audits of the Company’s subsidiaries’ formula marketing practices as well as independent external audits in case of multiple, broad scale allegations about non-compliance with the WHO Code by Nestlé. The latest Independent Assurance Statements of Nestlé’s subsidiaries’ compliance with the Code can be found at:

You indicate that “em>Nestle complementary foods are not marketed or presented as breast-milk substitutes” and that you support the May 2001 WHA Resolution that changed the recommended duration of exclusive breastfeeding from 4-6 months to 6 months. Given your support in this regard does this mean that you do not market any food/drink products at all for the use by infants under 6 months of age in any country and that none of your labels for cereal or baby food indicates that it can be used starting at 4 months?

Nestlé  fully supports the May 2001 WHA Resolution 54.2 which changed the recommended duration of exclusive breastfeeding from 4 – 6 month to 6 months, thereafter introducing complementary foods while recommending continued breast feeding for as long as possible. Thus we implement this resolution in the same way as we implement the WHO Code and we have completed label changes on complementary foods to follow the 6-months recommendation. In addition, in developing countries Nestlé applies the WHO Code not only to starter formula (0-6 months of age) but also to follow-on formula (6-12 months). It is the only major manufacturer to do so.

In discussions with the bloggers, your CEO mentioned that children died in the 1970s as a result of the misuse (wrong quantity, mixed with dirty water) of formula samples. Do you believe that deaths from the misuse of formula samples ended in the 1970s?

The WHO Code was adopted in 1981 to contribute to the provision of safe and adequate nutrition for infants, by protecting and promoting breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary.

Unfortunately, lack of clean water is still a reality in many developing countries. In these countries, mothers are advised not to use infant formula unless it is AFASS – acceptable, feasible, affordable, sustainable and safe.

However, if a baby is not breastfed for whatever reason, he or she needs a breast-milk substitute, whether or not clean water is available. Until all people have a safe water supply, the only solution is to teach mothers the importance of boiling water and how to prepare infant formula correctly.

All of Nestlé’s Infant Formula Labels contain the following text in the local language: “Warning: Unboiled water, unboiled bottles or incorrect dilution can make your baby ill. Only prepare one bottle at a time. Feed immediately. Do not keep unfinished bottle. Follow instructions exactly.”

In addition, the WHO Code states that it is the responsibility of health workers to advise mothers on infant feeding – first and foremost by encouraging and protecting breastfeeding, secondly to inform the mother about appropriate alternatives (advantages and disadvantages) which include instructions on how to prepare infant formula in a correct way.

It must also be underlined that the vast majority of women in developing countries breastfeed, and at the same time give their baby additional traditional foods, or just plain water. However, many poor mothers who need to use a breast-milk substitute cannot afford infant formula and therefore have to feed their babies with a potentially harmful substitute plain (including cornstarch water or other traditional food mixtures). The challenge is to educate mothers about appropriate breast-milk substitutes and complementary food that can be given to babies as well as to find a way to make appropriate substitutes available to those babies who really need it.

Why did your CEO tell bloggers at the Nestle Family event that the boycott ended in 1986reinstated in 1988 because Nestle did not live up to the promises it made. The boycott is is still active today. Please explain why you would attempt to mislead the bloggers about the status of the boycott.

In 1977, the first Nestlé boycott was lead by US-based INFACT and ended in 1984. At the end of 1988, an attempt was made to relaunch the Nestlé boycott but received little attention in the U.S.


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